tbuckley/cabot-search huggingface dataset:
POS1395-HPR EMOTIONAL INTELLIGENCE: A NOVEL OUTCOME ASSOCIATED WITH QUALITY OF LIFE IN PATIENTS WITH SYSTEMIC SCLEROSIS
Authors: D. Karagianni, D. Bogdanos, L. Sakkas
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Health related quality of life (HrQoL) in patients with systemic sclerosis (SSc), a systemic autoimmune disease, is severely impaired. Patients suffer from Raynaud's phenomenon, stiff hands, tight skin, pruritus, difficulty in swallowing, gastrointestinal disturbances, dyspnoea on exertion, and depression, significantly affecting their HrQoL. While several studies have addressed HrQoL in patients with SSc, no studies so far have investigated the trait emotional intelligence (TEI) of these patients. <h3>Objectives</h3> To investigate for the first time whether HrQoL of SSc patients is influenced by TEI in a cross-sectional study. <h3>Methods</h3> Sixty patients with SSc (Female: 86.67%) completed three questionnaires: TEI Questionnaire Short-Form (TEIQue-SF); Short-Form Health Survey (SF-36); and demographic characteristics. A series of multiple linear regression models were used to analyze the data with dependent variables (DV) every dimension of SF-36 (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, Mental Health) and independent variables TEI total and every TEI factor (Well-being, Self-control, Emotionality, Sociability). <h3>Results</h3> The average age of participants was 56.4±13.4 years and the mean disease duration was 7.7±7.5 years. TEI total was found to affect both physical and mental component summaries (p&lt;0.001) and all 8 dimensions of the HrQoL (p&lt;0.001). Well-being appeared to have a positive effect on Role-Physical, General Health, Vitality, Social Functioning and Mental Health. Self-control appeared to influence Physical Functioning and Pain, and Emotionality appeared to influence Role-Emotional. Sociability was not an important factor for any dimension of HrQoL (Table 1). <h3>Conclusion</h3> Understanding the relationship between TEI and HrQoL dimensions is important for the support and empowerment of SSc patients, as well as the establishment and implementation of appropriate psychotherapeutic interventions. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1286 ARRHYTHMIA IN PATIENTS WITH SYSTEMIC SCLEROSIS: A SWEDISH REGISTER-BASED STUDY
Authors: M. Bairkdar, Z. Dong, P. Andell, R. Hesselstrand, M. Holmqvist
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc) is a connective tissue disease with multiple organ manifestations including cardiac involvement. Several studies have reported arrhythmias and conduction defects to be frequent in patients with SSc, however with considerable limitations such as the lack of comparison group or of stratified analyses by arrhythmia subtypes in some studies in addition to some study populations being highly selected from tertiary care centres. <h3>Objectives</h3> To explore the incidence of cardiac arrhythmias and its different subtypes in an unselected national cohort of patients with SSc compared to a matched cohort from the general population in Sweden. <h3>Methods</h3> We used nationwide Swedish registers to identify patients with incident SSc diagnosed between 2004 and 2015 in addition to comparators from the general population (1:5), matched on sex, birth year and residential area. We excluded those with a history of arrhythmia prior to start of follow-up. The primary outcome was the first ICD-coded visit indicating arrhythmia. Follow-up started from the date of SSc diagnosis, the same date was assigned to the respective comparators, until the primary outcome, death, emigration, or the end of 2016. We estimated the incidence rate of arrhythmias overall and stratified by subtype of arrhythmia in both patients with SSc and their comparators. We estimated incidence rate ratios (IRRs) using poisson regression models and time-varying hazard ratios (HRs) using flexible parametric models. <h3>Results</h3> We identified 1049 patients with SSc and 5147 matched comparators with no prior history of arrhythmia. The median follow-up was 4.7 years in patients with SSc and 5.8 years for the comparators. The incidence rate of arrhythmias overall was 216.5 per 10,000 person-years (95% CI 179.8-258.5) in patients with SSc and 106.6 (95% CI 95.5-118.7) in the comparators corresponding to IRR of 2.0 (95% CI 1.7-2.5). Table 1 demonstrates the incidence rates and IRRs stratified by arrhythmia subtypes. The HR of arrhythmia overall in patients with SSc compared to the comparators decreased gradually during follow-up; 3.0 (95% CI 2.2-4.1) at the end of the first year of follow-up, 1.9 (95% CI 1.4-2.5) at the end of the fifth year of follow-up, and 1.3 (95% CI 0.8-2.3) at the end of the 10th year of follow-up. <h3>Conclusion</h3> Patients with SSc have higher incidence rate of arrhythmia overall compared with matched comparators from the general population. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Majd Bairkdar: None declared, Zihan Dong: None declared, Pontus Andell: None declared, Roger Hesselstrand Speakers bureau: Boehringer Ingelheim and Janssen-Cilag, Employee of: Boehringer Ingelheim, Marie Holmqvist: None declared.
POS1302 SPECKLE-TRACKING GLOBAL LONGITUDINAL STRAIN AS A PREDICTOR OF CLINICAL OUTCOMES IN SYSTEMIC SCLEROSIS PATIENTS
Authors: D. Benfaremo, G. Stronati, C. Dichiara, Y. Ferraioli, C. Tana, I. Paterno, S. Bigoni, S. Contegiacomo, M. Sistoni Pepparoni, N. Pacenti, A. Dello Russo, F. Guerra, G. Moroncini
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary cardiac involvement occurs in up to 40% of patients affected by systemic sclerosis (SSc), and although it may be asymptomatic is associated with negative outcomes. Speckle-tracking derived global longitudinal strain (GLS) has been proven to be a cost-effective tool in the detection of left ventricular (LV) and right ventricular (RV) dysfunction in patients with SSc and no overt cardiac disease <sup>[1]</sup>. <h3>Objectives</h3> The aim of this study was to assess whether GLS can predict clinical outcomes in patients with SSc. <h3>Methods</h3> We conducted a prospective observational study enrolling all consecutive patients referred to our Scleroderma Unit between June 2016 and January 2022. All patients had a definite diagnosis of SSc according to ACR/EULAR criteria and no overt cardiac disease, pulmonary arterial hypertension, or atrial fibrillation at the time of enrollment. For each patient, echocardiogram and GLS calculations were performed at baseline and at each follow-up. We also collected all data regarding clinical history, hospitalizations or adverse events and ECGs. <h3>Results</h3> 164 patients (148 female, 58±14 years) were enrolled. Overall, 19 (11.6%) patients died during a median follow-up of 3.2 years for mainly non-cardiovascular deaths (7.3%) while cardiovascular deaths were lower (3% non-sudden, 1.3% sudden). Left GLS at first visit was associated with all-cause death, with a 1% left GLS worsening associated with a 19% increased risk of death after adjusting for age, gender, and LVEF (adjusted HR 1.19; 95% CI 1.05-1.35; p=0.007). Similarly, right GLS at first visit was associated with all-cause death, with a 1% right GLS worsening associated with a 12% increased risk of death after adjusting for age, gender, and TAPSE (adjusted HR 1.12; 95% CI 1.03-1.21; p=0.005). Patients with a left GLS worse (i.e. higher) than -20% had a 3.5-fold increased risk of death when compared to patients with better left GLS (HR 3.55; 95% CI 1.28-9.88; p=0.015; Figure 1a). Similarly, patients with a right GLS worse than -20% had a 4.5-fold increased risk of death when compared to patients with better left GLS (HR 4.47; 95% CI 1.4-13.74; p=0.009; Figure 1b). <h3>Conclusion</h3> We demonstrated that GLS is associated with clinical outcomes in patients with SSc. GLS is a reproducible and cost-effective echocardiographic based method to assess SSc primary heart involvement and its progression, therefore allowing an earlier intervention in patients with worse prognosis. <h3>Reference</h3> [1]Guerra F, et al. Global longitudinal strain measured by speckle tracking identifies subclinical heart involvement in patients with systemic sclerosis. Eur J Prev Cardiol. 2018 Oct;25(15):1598-1606. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1290 INCREASED RISK OF MYOCARDIAL INFARCTION AND STROKE IN PATIENTS WITH SYSTEMIC SCLEROSIS: A NATIONWIDE COHORT STUDY
Authors: Y. Eun, K. D. Han, J. K. Ahn
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Previous studies have suggested a link between systemic sclerosis (SSc) and cardiovascular disease, but large-scale data are still lacking due to the nature of rare autoimmune diseases. <h3>Objectives</h3> We aimed to compare the incidence of myocardial infarction (MI) and stroke in patients with SSc and age- and sex-matched controls in a nationwide population-based cohort in Korea. <h3>Methods</h3> We included patients with SSc defined by the ICD-10 code (M34) and rare and intractable disease code (V138) and 1:5 age- and sex-matched controls using the Korean National Health Insurance Database. The outcomes of the study were MI and stroke. Cox proportional hazard analysis and Kaplan-Meier curve were used to compare the incidence of outcomes between patients with SSc and controls. <h3>Results</h3> A total of 4700 patients with SSc and 23500 controls were included in the study. The mean follow-up period was 5.6 ± 2.8 years. At baseline, patients with SSc had higher prevalent rates of comorbidities such as hypertension, hyperlipidemia, and congestive heart failure than controls. Patients with SSc had a 3-fold higher risk of MI (adjusted hazard ratio [aHR] 3.01, 95% confidence interval [CI] 2.41–3.76) and a 1.7-fold higher risk of stroke (aHR 1.65, 95% CI 1.28–2.14) compared to controls. There were no differences in the association between SSc and MI or stroke by age, sex, or comorbidities. <h3>Conclusion</h3> This nationwide population-based cohort study revealed an association between SSc and increased risk of MI and stroke. Therefore, careful monitoring and preventive measure for the cardiovascular diseases in patients with SSc are required. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1441 OCULAR AND PERIPHERAL BLOOD IMMUNE PHENOTYPES SUGGEST TRANSMIGRATION OF CD16+ MONOCYTES TO AN IMPORTANT EFFECTOR SITE IN BEHÇET’S DISEASE
Authors: Y. Ozguler, Z. Lin, G. Hatemi, A. Cavers, J. Nowatzky
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Cellular immunity of Behçet's Disease (BD) remains poorly understood. Previous work has provided clues pointing to most innate and adaptive immune cell types in BD, but strong signals from non-immunogenetic studies are rare and often inconclusive. <h3>Objectives</h3> Here we aimed to identify BD/HD discriminant single immune cell profiles in semi-biased and targeted approaches and determine their significance at a BD relevant effector site. <h3>Methods</h3> We utilized multi-parametric flow cytometry to dissect cellular phenotypes in PBMC of untreated BD patients (n=27) and HD (n=22) consisting predominantly of active ocular and major vascular BD subjects. Data were subjected to supervised machine learning (CITRUS) and results verified with targeted gating. We also analyzed anterior chamber (AC) fluid cells and autologous PBMC from BD uveitis subjects with scRNA seq. <h3>Results</h3> CITRUS identified CD16+, CD14low, CD4low, CD3-, CD19- cells as a BD/HD distinguishing cellular expression pattern at an FDR of &gt;0.05. Targeted gating confirmed highly significant differences with large effect sizes in PBMC of BD vs HD for "non-classical" (CD14lowCD16hi) and "intermediate" (CD14+CD16+) monocytes at decreased frequencies compared to peripheral blood. "Classical" (CD14++CD16-) monocytes were more abundant in BD PBMC than in HD. CD16+ dendritic cells (DC) were significantly decreased in BD PBMC. CD14+ cells showed high abundance in the AC during BD uveitis and co-expressed CD16 far more frequently than CD14+ cells in autologous peripheral blood. <h3>Conclusion</h3> Significantly lower frequencies of CD16+ monocyte and DC subsets in PBMC of untreated active BD vs HD strongly point to their importance in BD. The high abundance of CD14+ cells with CD16 co-expression in the eye during uveitis relative to their frequency in autologous peripheral blood, suggests their transmigration or post-migrational interconversion within the eye during BD uveitis rather than a stochastic process. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Yesim Ozguler: None declared, Ziyan Lin: None declared, Gulen Hatemi: None declared, Ann Cavers: None declared, Johannes Nowatzky Grant/research support from: NIH-NEI R01EY031383 (Nowatzky), NIH-NEI R01EY033495 (Nowatzky)
POS1330 LUNG ULTRASOUND FOR THE FOLLOW-UP OF SYSTEMIC SCLEROSIS-RELATED INTERSTITIAL LUNG DISEASE TREATED WITH NINTEDANIB: OUTCOMES AND COMPARISONS WITH OTHER ASSESSMENT TOOLS
Authors: M. Di Battista, A. Della Rossa, M. Da Rio, C. Romei, A. Delle Sedie, M. Mosca
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Nintedanib (NIN) is an antifibrotic drug used to slow the progression of systemic sclerosis-related interstitial lung disease (SSc-ILD), reducing the decline in forced vital capacity (FVC). High-resolution chest tomography (HRCT) is the gold standard imaging technique to assess SSc-ILD, whereas lung ultrasound (LUS) is a useful and repeatable non-invasive tool which is increasingly used in clinical practice. <h3>Objectives</h3> The aim of this work was to investigate the usefulness of LUS during the follow-up of SSc-ILD patients treated with NIN. <h3>Methods</h3> Adult SSc patients starting NIN for ILD were enrolled and followed for 12 months. LUS was performed at baseline and quarterly on 55 antero-posterior spaces, evaluating pleural line irregularities (PLI; semi-quantitative score 0-1-2) and the number of B-lines (BL), according to OMERACT definition. FVC was investigated every six months, whereas HRCT was performed at baseline and at 12 months. The following patient-reported outcomes were administered quarterly: Leicester cough questionnaire and St.George respiratory questionnaire. During follow-up, all of the aforementioned investigations were assessed for stability, improvement, or worsening from baseline, then evaluating the concordance with LUS variations. <h3>Results</h3> Ten SSc-ILD patients (70% female, mean age 62±10.9 years) starting NIN were enrolled. One patient had to prematurely discontinue NIN due to unbearable gastrointestinal adverse effects. The other 9 patients were followed for 12 months, achieving FVC stabilization in 87.5% of the cases. The mean PLI score and the mean BL number both showed a declining trend over time (Figure 1), with a 12-months significant overall reduction (p=0.02 for PLI; p&lt;0.01 for BL). At the final evaluation, both PLI and BL were improved in 55.5% of the cases and stable in the rest, whereas HRCT resulted worsened in 62.5% of patients and stable in the rest. The concordance of these two imaging techniques was very low (12.5%). LUS concordance with FVC was quite good (61.5% for PLI and 46.1% for BL). Moreover, PLI variations showed a greater concordance for Leicester cough questionnaire and St.George respiratory questionnaire (69.2% and 42.3%, respectively) than BL variations (35.7% and 28.5%, respectively). <h3>Conclusion</h3> We performed LUS for the follow-up of SSc-ILD patients treated with NIN. Changes in PLI and BL fairly closely reflected the functional and subjective trend of the patients. PLI variations showed a good correlation with the outcomes of FVC and cough questionnaires. HRCT seems to progress regardless of the efficacy of NIN on lung function, therefore LUS could be used for monitoring SSc-ILD patients receiving NIN. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1402-HPR BODY MASS INDEX MAY HAVE A ROLE IN THE PROGRESSION OF STRUCTURAL DAMAGE IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS
Authors: E. Erpek, E. Durak Ediboglu, K. A. Sinci, E. Otman Akad, H. Kocaayan, G. Alp, H. Cinakli, A. Özkan, İ. Kurut Aysin, M. Ozmen, S. Gucenmez, O. Tosun, D. Solmaz, S. Akar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Objectives</h3> To examine the association between basline body mass index (BMI) and progression of radiographic damage in axial spondyloarthritis (ax-SpA) patients. We also assessed the correlation between baseline BMI and baseline radiographic damage in terms of mSASSS score and the presence of syndesmophytes. <h3>Methods</h3> In total 657 (431[65.6%] r-axSpA and 226 nr-axSpa; 243 [37%] female and mean age of 39.9 ± 11.7 years) patients classified as axSpA according to the "Assessment of Spondyloarthritis International Society [ASAS]" criteria were included in the study. mSASSS progression was defined as at least 2 units mSASSS score increase on radiographs taken at least two years apart. An increase in mSASSS score and/or the development of new syndesmophyte was considered as radiolographic progression. <h3>Results</h3> Age, age at diagnosis, symptoms duration and education level were significantly different between the patients with BMI&lt;30 and BMI≥30. BASDAI, C-reactive protein and erythrocyte sedimentation rates were similar between groups. BASFI, BASMI, fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein levels and aspartate aminotransferase values measured in the same period were significantly higher in axSpA patients with BMI≥30. While baseline total and lumbar vertebrae mSASSS scores were similar between the groups, cervical mSASSS scores were significantly high in the BMI≥30 group. In our study group baseline BMI was positively correlated with radiographic progression (r=0.201; P=&lt;0.005) and the development of new syndesmophyte (r=0.134; P=&lt;0.05). <h3>Conclusion</h3> The results of this study showed that BMI was associated with both basline and the progression of structural damage in axSpA patients. The effect of high BMI on structural damege may be related to mechanical factors. However, BMI was found to be associated with cervical, but not lumbar syndesmophyte at baseline. Thse findings might be the results of increase in proinflammatory cytokines such as TNF-alfa and IL-6 and the reduction of anti-inflammatory cytokines such as IL-10 and adiponectin secreted from dysfunctional adipose tissue. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0234 PROGNOSTIC POTENTIAL OF EXOSOMES (EX) AS IMMUNOMODULATORS IN SYNOVIAL FLUID (SF) IN RHEUMATOID ARTHRITIS (RA)
Authors: E. De La Poza Plaza, S. Barykin, V. Shishkin, V. V. Shishkin, G. V. Kudryavtseva
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Secretory EX various biological fluids, including synovial, – key mediators of intercellular communication, regulating the body's immune responses, information transfer, vesicular transport, etc. Penetrating into cells, EX can cause a cascade of changes in them at the genomic and epigenomic levels. <h3>Objectives</h3> The aim of the study was to assess the degree of expression of exosomal membrane proteins and endonucleases from SF in RA. <h3>Methods</h3> SF of knee joints of 10 patients with RA with active synovitis and 7 conditional donors postmortem (D) were researched. EX was isolated by ultrafiltration and double ultracentrifugation (105 g).EX was identified by transmission electron microscopy and flow cytometry. The expression level of tetraspanins (CD9, СD81) and chaperones (Hsp70, Hsp90) was determined (conv. units) by flow cytofluorimetry and by immunoblotting, respectively. The activity of endonucleases of EX (units/ml) was carried out spectrophotometrically. <h3>Results</h3> In RA, there is a pronounced expression of transmembrane markers of exosomes: tetraspanins СD9 and СD81 (on the surface of exosomes) and chaperones Hsp70 and Hsp90 (obligate internal components). The levels of major tetraspanins CD9 and Hsp70 were significantly increased (by 3.2 and 2.2 times, respectively). Functional groups of proteins such as acidic and alkaline endonucleases show multidirectional changes in EX with RA: a sharp increase in the activity of acidic DNA-as and RNA-as (by 55-30 times) and a 2-3-fold decrease in the activity of alkaline analogues (Table 1). It is obvious that the shift of the pH of SF at RA (on average, from 7.75 units in normal to 7.21 – at RA) noted by many authors, affects the implementation of exosomal secretion of proteins and nucleic acids, which disrupts the immunomodulatory intercellular signaling. <h3>Conclusion</h3> EX-secretion of proteins and nucleic acids in RA can be not only a fundamental way of intercellular communication, but also an immunomodulatory factor of etiopathogenetic significance. EX obtained from SF have potential prognostic value in the study of immunocomplex pathologies. <h3>Reference</h3> [1] Shishkin V.I. et al. DOI:10.1136/annrheumdis-2020-eular.1258 P1368 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1425 ANTIB2GLYCOPROTEIN I ANTIBODIES CAN INDUCE NETOSIS
Authors: S. Mancuso, C. Giacomassi, S. Truglia, C. Barbati, C. Alessandri, E. Corsiero, M. Caliste, M. Lewis, M. Bombardieri, F. Conti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> NETosis has been described to play a role in the pathogenesis of APS. IgG and sera of APS patients are known to induce NETosis [1], however the direct role of aβ2GPI on NETosis is not fully known. <h3>Objectives</h3> The aim of this study is to evaluate the interplay between NETosis and aβ2GPI antibodies. <h3>Methods</h3> HD neutrophils were stimulated either with polyclonal aβ2GPI isolated from a serum pool of primary APS, with immunoglobulin isolated from HD (IgHD) or PMA. NETs were stained with anti-neutrophils elastase, SYBR green and DAPI. NET quantification was performed with NETQUANT, an automated approach. To evaluate the ability of aβ2GPI to bind to NET, HD neutrophils were stimulated with PMA and stained with anti-neutrophil elastase, SYBR green and with aβ2GPI and, as a control, with IgHD instead of aβ2GPI. Colocalization of aβ2GPI and NET signal was performed with Just Another Co-localization Plugin (JACoP). In order to evaluate the ability of aβ2GPI to bind to NETs and prevent DNA degradation, incubation with DNase I was also performed. <h3>Results</h3> Stimulation of HD neutrophils with aβ2GPI was able to induce a significantly higher number of NETs compared to stimulation with IgHD (77.6% vs 20%, p&lt;0.0001). The prevalence of NETs in stimulated IgHD and unstimulated neutrophils was similar (20% vs 16%, p=ns). Two different shapes of NET were identified in neutrophils stimulated with aβ2GPI: "cloudy-like" and "spiky-like". Unlike IgHD, aβ2GPI binds to NETs (Figure 1), and the aβ2GPI signal colocalized with the anti-neutrophil elastase signal at 93.6%. In addition, we showed that aβ2GPI binding to NETs did not prevent NETs degradation by DNase. <h3>Conclusion</h3> Aβ2GPI antibodies are able to induce NETosis and to bind to NETs. <h3>Reference</h3> [1]Knight JS, Kanthi Y. Mechanisms of immunothrombosis and vasculopathy in antiphospholipid syndrome. Semin Immunopathol. 2022;44:347-62. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.